According to the report on the situation of COVID-19 from the Center for COVID-19 Situation Administration (CCSA), Department of Disease Control, Ministry of Public Health (Ministry of Public Health) as of August 2, 2021, Thailand has 633,284 confirmed cases with 5168 deaths, a 10-fold increase compared to January in the same year (Department of Disease Control Ministry of Public Health, 2021).

Due to the large number of people suffering from the Coronavirus Disease 2019 and needing multi-dimensional care in terms of complication prevention, treatment, and referral, hospitals at all levels are unable to meet the increasing needs of service. Therefore, quarantine in a place provided by the government in the community (Community Isolation) is another option to treat patients and reduce the spread in the community. Thailand had 766 quarantine facilities across the country that could accommodate up to 21,302 people.

Therefore, in order to achieve maximum efficiency in caring for patients quarantining in the communities and at their homes. The Faculty of Nursing sees the importance of management and sharing services with related agencies for community isolation in the management of CI, follow-up, counseling, and referral of COVID-19 patients to reduce the loss that will occur in all aspects. It is in line with the Faculty's strategy in providing academic services for sustainable development of the health of society.

Objectives

Cooperating with Nakhon Pathom Provincial Health Office, Golden Jubilee Medical Center and Mahidol University, in managing and providing standard services to COVID-19 patients that are doing community isolation and home isolation in Nakhon Pathom and Bangkok

The implementation of the project is as follows:

1. Projects in collaboration with Golden Jubilee Medical Center

There were 65 faculty members in the Faculty of Nursing joining Home Isolation (HI) services with Golden Jubilee Medical Center (GJ). Each person provided services to 5 HI patients per day through screening and caring along with standard criteria by coordinating through the GJ application that has a team of doctors, nurses, and pharmacists joining in providing services.

2. Community Isolation in Phutthamonthon District

There were meetings with Nakhon Pathom Provincial Health Office and Public Health of Phutthamonthon District to jointly plan the implementation of Community Isolation (CI) together. There were 4 CIs available and each was managed differently. The Department of Public Health Nursing, Faculty of Nursing, was the main department in operation by dividing faculty members into 2 teams, taking care of 2 CIs per team. CI at Mahasawat Hospital and CI at the College of Dramatic Arts had been opened as follows:

2.1 Community Isolation at Maha Sawat Tambon Health Promoting Hospital

The faculty members participated in the supervision and management of CI in Mahasawat sub-district by co-designing the CI supervision and management system. The team also went to the area to prepare the place, determine the zone of the patient's area, manage environmental sanitation, and organize the CI management system by using the area of Ban Khlong Maha Sawat School, which consists of a 2-floor building with 50 beds. The area can receive 1) Green and yellow patients who have just been diagnosed and confirmed at home and 2) patients from field hospitals come to recuperate for 14 days before discharged. In addition, the faculty team also worked with the personnel team and Village Health Volunteers of Maha Sawat Tambon Health Promoting Hospital to provide the following services.

1. Organizing nursing rounds in the morning and afternoon every Friday

2. Monitoring patients through the Line application by giving advice to newly admitted patients and taking care of and managing patients with high fever, dyspnea, or other complications by emphasizing on giving advice, solving problems, and providing antiviral medication to patients by coordinating with the responsible doctors from Phutthamonthon Hospital

3. Developing a data storage system and create a basic database

4. Developing a system to prevent the spread of infection, a guideline for food and drug delivery services, and infectious waste management, etc.

5. Developing rules and regulations for preparing for community isolation practices for different groups of patients, and summarizing the number of service recipients/patients. The operation was started on July 28, 2021. There were a total of 34 patients were admitted for CI care; 9 people were discharged, and there were 25 active cases.

2.2 Community Isolation at the College of Dramatic Arts

Faculty members jointly planned management actions and administer Community Isolation where green, dark green, and yellow patients were admitted. There were village health volunteers in the area and patients would report symptoms in morning and evening via Line Application. Faculty members assisted in monitoring symptoms of patients in CI by coordinating for appropriate care from doctors that can consult and order treatment, available 24 hours a day. Two staff from Maha Sawat Tambon Health Promoting Hospital together to monitored symptoms and coordinated to give medication to patients or intervention according to the treatment plan, such as x-rays. On August 18, 2021, there were 69 patients receiving services; 23 active cases and 46 discharged. The patients who returned home would receive a medical certificate issued by Phutthamonthon Hospital.

3. Community Isolation with Mahidol University via Com Covid

Faculty members accepted patients from communities including villages, factories, or schools that had 5 or more infected people enrolling with Com Covid.

Nurses would monitor the patient's condition by looking at vital signs of symptoms from Covid-19, and from congenital disease twice a day. If abnormalities are found, nurses would report to a doctor to prescribe treatment for 14 days. If the symptoms turned red, the patient would be sent to any hospital that can be contacted at that time. There were seven communities that all patients received standard care and referrals, with no death reported.